老年性骨质疏松性骨折的发生与预防

The occurrence and prevention of osteoporotic fractures in the elderly

骨质疏松性骨折是一项在老年人中极为常见和严重的健康问题。随着人口的老龄化,骨量丢失在变成一个日益严重的临床问题。然而老年人骨量丢失这个情况很少被人们发觉,因而不能得到很好的治疗。除了骨矿物含量密度(骨密度)的下降,导致骨质疏松性骨折的因素常与影响姿势稳定性的神经肌肉失调有关。骨质疏松性骨折的预防围绕充足的矿物营养,包括每日钙和维生素D的供应以及抗骨吸收药物的应用,两者都可以降低骨折发生风险。预防骨折还需要预防跌倒,并减少跌倒产生的冲击力。因此,药物和非药物干预同样重要。本综述也探讨了骨折风险预测工具(FRAX)的使用,它可以通过使用患者的特定数据来预测特定时间内骨折的风险。当前,老年性骨质疏松症仍缺乏诊断和治疗,但年龄并不能成为骨质疏松性骨折干预的障碍。

Osteoporotic fracture is an extremely common and serious health problem in the elderly.With the aging of the population,bone loss is an increasing clinical issue for both men and women.However the bone loss in the elderly is often ignored and is not treated properly.Besides the declining of bone mineral density（BMD）,factors contributing to osteoporotic fractures are often associated with disordered neuromuscular function which affects postural stability.Prevention of osteoporotic fractures focuses on adequate mineral nutrition,including daily calcium and vitamin D supplementation,as well as the prescription of antiresorptive medications.Both can reduce the potential fracture risk.Fracture prevention requires the prevention of falls and reduction of the impact force of falls.Thus,both pharmacological and nonpharmacological intervention are equally important.This review also investigates the use of fracture risk assessment tools（FRAX）,which can predict timely fracture risks according to specific patient data.Currently,senile osteoporosis lacks diagnosis and treatment,but age should not be a barrier of intervention of osteoporotic fracture.